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System Formulary Update
HIV Nucleoside Reverse Transcriptase Inhibitors (NRTI)

Situation

The NRTI class review and formulary standardization was approved at the August 2020 System Pharmacy and Therapeutics Committee meeting.

Background

The following medications were reviewed: abacavir, didanosine, emtricitabine, lamivudine, stavudine, tenofovir disoproxil, zidovudine, and combinations of the aforementioned agents.

Assessment/Recommendations

Changes Effective: Tuesday, February 23, 2021

System P&T voted to include the following products on the UNC Health System Drug Formulary:

• Abacavir tablet: 300 mg
• Abacavir/lamivudine tablet: 600 mg/300 mg
• Emtricitabine capsule: 200 mg
• Emtricitabine/tenofovir alafenamide: 200 mg/25 mg
• Emtricitabine/tenofovir disoproxil: 200 mg/300 mg
• Lamivudine tablet: 100 mg, 150 mg, 300 mg
• Lamivudine oral solution: 10 mg/mL
• Tenofovir disoproxil (TDF) tablet: 300 mg
• Zidovudine oral syrup: 10 mg/mL
• Zidovudine tablet: 300 mg
• Zidovudine IV solution: multiple strengths
• Abacavir/dolutegravir/lamivudine tablet: 600 mg/50 mg/300 mg
• Bictegravir/emtricitabine/TAF tablet: 50 mg/200 mg/25 mg

Note: Stock of these formulary products may vary at individual entities

As a result, the following products will be removed from the inpatient drug formulary:

• Abacavir/lamivudine/zidovudine tablet: 300 mg/150 mg/300 mg
• Didanosine oral solution: 10 mg/mL
• Didanosine oral packet: 250 mg
• Dolutegravir/lamivudine tablet: 50 mg/300 mg
• Emtricitabine oral solution: 10 mg/mL
• Emtricitabine/TDF: 100 m/10 mg
• Lamivudine oral solution: 5 mg/mL
• Lamivudine/zidovudine tablet: 150 mg/300 mg
• Lamivudine/TDF tablet: 300 mg/300 mg
• Stavudine oral solution: 1 mg/mL
• Stavudine capsule: 30 mg
• Tenofovir disoproxil fumarate tablet: 150 mg
• Zidovudine capsule: 100 mg